November 2017

Unexpected gap payments and difficult conversations

Frustrated – what is the point of private health insurance if all the medical specialists just want more money?

Voice Your Choice member

With the help of our Voice Your Choice members, we investigated how immune patients are to gap payments if they hold private health insurance.

We found that even if members held insurance before surgery, many were still saddled with out-of-pocket costs. These costs were often higher than expected and many patients felt uncomfortable discussing these payments with the doctor entrusted with their medical care.

This highlights the need for greater transparency of health insurance policies so consumers are aware of the potential gap payments they'll face. Patients also need to feel empowered to discuss these costs with their doctors without feeling like they are compromising the doctor/patient relationship.

Of those members undertaking surgery:

68% incurred gap payments

Of those with gap payments:

44% found this gap payment was higher than expected

29% felt uncomfortable discussing these costs.

Total sample n=697, VYC members

So far, we've made it easier to find the best health insurance policy for you, and we're investigating gap payments.